下腔静脉呼吸变异指数对老年全麻宫颈癌根治术患者发生低血压的预测价值
Predictive value of inferior vena cava respiratory variation index for hypotension in elderly patients undergoing radical resection of cervical cancer under general anesthesia
刁怀悦 1陈福腾 1高顺恒 1朱梦雪 1顾小姣1
作者信息
- 1. 江苏省连云港市第一人民医院麻醉科,江苏连云港 222000
- 折叠
摘要
目的 探讨下腔静脉呼吸变异指数(IVC-RVI)对老年全麻宫颈癌根治术患者发生低血压的预测价值.方法 回顾性分析 2020 年 9 月至 2023 年 5 月江苏省连云港市第一人民医院行全麻宫颈癌根治术治疗的 107 例老年宫颈癌患者的临床资料.根据术后48h内是否发生低血压分为低血压组、非低血压组.比较两组临床资料,分析影响老年全麻宫颈癌根治术患者发生低血压的相关因素;IVC-RVI对老年全麻宫颈癌根治术患者发生低血压的预测价值采用受试者操作特征曲线.结果 107 例行老年全麻宫颈癌根治术的患者中有 36 例(33.64%)发生低血压.低血压组合并高血压占比、肺毛细血管楔压、中心静脉压、IVC-RVI高于非低血压组,术前使用血管收缩性药物占比低于非低血压组(P＜0.05).合并高血压、IVC-RVI是老年全麻宫颈癌根治术患者低血压发生的危险因素(OR=2.881、3.235,P＜0.05),术前使用血管收缩性药物是保护因素(OR=0.334,P＜0.05).IVC-RVI预测老年全麻宫颈癌根治术患者低血压发生的灵敏度、特异度及曲线下面积分别为 88.89%、87.32%、0.869.结论 超声IVC-RVI对老年全麻宫颈癌根治术患者发生低血压的预测价值较高.
Abstract
Objective To investigate the predictive value of inferior vena cava respiratory variation index(IVC-RVI)for hypotension in elderly patients undergoing radical resection of cervical cancer under general anesthesia.Methods The clinical data of 107 elderly patients with cervical cancer who underwent radical resection of cervical cancer under general anesthesia in Lianyungang First People's Hospital,Jiangsu Province from September 2020 to May 2023 were retrospectively analyzed.They were divided into hypotensive group and non-hypotensive group according to whether hypotension occurred within 48 hours after operation.Clinical data were compared between two groups,and the related factors affecting hypotension in elderly patients underwent radical resection of cervical cancer under general anesthesia were analyzed;the predictive value of IVC-RVI for hypotension in elderly patients underwent radical resection of cervical cancer under general anesthesia was determined by receiver operating characteristic curve.Results Thirty-six(33.64%)of 107 elderly patients underwent radical cervicectomy under general anesthesia had hypotension.The proportion of hypertension,pulmonary capillary wedge pressure,central venous pressure,and IVC-RVI in hypotension group was higher than those in non-hypotension group(P＜0.05),and the proportion of preoperative vasoconstrictor drug use was lower than that in non-hypotension group(P＜0.05).Hypertension and IVC-RVI were risk factor for hypotension in elderly patients underwent radical cervicectomy under general anesthesia(OR=2.881,3.235,P＜0.05),and preoperative vasoconstrictor drug use was a protective factor(OR=0.334,P＜0.05).The sensitivity,specificity,and area under the curve of IVC-RVI for hypotension in predicting hypotension in elderly patients underwent radical resection of cervical cancer under general anesthesia were 88.89%,87.32%,and 0.869,respectively.Conclusion IVC-RVI has high value in predicting hypotension in elderly patients undergoing radical resection of cervical cancer under general anesthesia.
关键词
老年/宫颈癌/超声/下腔静脉呼吸变异指数/低血压Key words
Elderly/Cervical cancer/Ultrasound/Inferior vena cava respiratory variation index/Hypotension引用本文复制引用
基金项目
江苏省卫生健康委科研项目(LGY2018050)
出版年
2024
NETL
NSTL
万方数据